Pediatrician Nadine Burke Harris Explains How Childhood Trauma Can Have Lasting Health Impacts
Childhood trauma leaves lasting damage on people’s psyches. There is growing awareness in the medical community that experiencing adversity as a child leaves lasting impacts on a person’s body as well, including higher risks for heart disease and cancer.
That realization dates back to a landmark research study from the 1990s into what are known as Adverse Childhood Experiences, or ACEs.
Doctors are now increasingly having their patients fill out surveys that ask questions such as whether they experienced physical or sexual abuse growing up, lived with someone who was a problem drinker or had a family member who went to prison. Doctors then add up the “yes” answers to get a patient’s ACE score.
People with an ACE score of four or more are twice as likely to develop heart disease and cancer and 3.5 times as likely to develop chronic obstructive pulmonary disease as someone with no ACEs.
Pediatrician Nadine Burke Harris has made it her mission to get this information out to the world. She founded the Center for Youth Wellness in San Francisco and saw firsthand the health impacts her own patients were experiencing – things like asthma and autoimmune diseases – which she deduced stemmed from living through trauma and a lot of stress.
In the book, Burke Harris wrote that she started focusing on the impact of childhood adversity after seeing a patient named Diego. He was seven years old but no bigger than a four-year-old. He had asthma and eczema and was having attention problems in school. His mother eventually revealed to Burke Harris that he had been molested by a family friend when he was four years old.
“Looking at his growth charts, it looks like he experienced growth arrest right around the same time as his sexual trauma, and that for me was the thing that got me thinking differently about how I approach these issues in my patients,” Burke Harris said. “It was this question of: Could it be possible that the trauma he experienced is not only the cause of his behavioral problems, but also the cause of all of his health problems?”
That set her on a path to figuring out how toxic stress in childhood does lasting physical damage. People who have lived through a lot of childhood adversity are at higher risk for strokes, obesity and even Alzheimer’s disease, she said.
“When you have an overactive stress response, not only does that lead to changes in brain structure and function, it also leads to change in the structure and function of things like the immune system, so we see chronic inflammation that can be measured even into adulthood,” she said.
Burke Harris said that instead of viewing this information as depressing or scary, she feels hopeful because arming doctors and patients with that knowledge can help improve treatment and ultimately, health outcomes.
“This biological process has been going on forever. We just didn’t recognize it and we weren’t able to use it for treatment,” she said. “Now we know that we can actually target normalizing the stress response.”
She says sleep, mental health, mindfulness, healthy relationships, exercise and nutrition are the best ways to heal an overactive stress response.
Regular exercise “helps to metabolize stress hormones and release healthy hormones like endorphins that counteract the effect of the stress response,” she said. Meditation reduces stress hormones and inflammation and improves brain functioning.
One thing Burke Harris wants to make clear is that childhood adversity is not limited to low-income populations. She said that’s one of the biggest myths that exist about adverse childhood experiences.
“When I talk to friends and colleagues and patients who come from middle- and upper-income communities, what they say is, `Oh my goodness, this has been going on for so long, but we never talk about it,’” she said.
She said whether the reason for that is secrecy or shame, the end result is that by ignoring or diminishing the existence of childhood trauma, it “adds to the intergenerational cycle of adversity.”
Burke Harris said only four percent of pediatricians in the U.S. survey patients for childhood adversity. That’s something she’s trying to change.
“I will tell you, I’m a woman on a mission trying to make sure that we dramatically increase the number of pediatricians who are screening for adverse childhood experiences,” she said. “Because when we do early interventions, it improves outcomes.”